Family doc practicing as an "acne specialist" - grossing over 900k ??

[RyanMaverick]

The fact that he was "cash-poor" and soliciting loans from his patients certainly doesn't paint a very pretty picture for him and makes the stress/book keeping story hard to believe.

[apache]

he has too pay back the 100 grand before he goes back into practice too... that could be a pain for him

 

The fact that he was "cash-poor" and soliciting loans from his patients certainly doesn't paint a very pretty picture for him and makes the stress/book keeping story hard to believe.

[Jochi1543]

The fact that he was "cash-poor" and soliciting loans from his patients certainly doesn't paint a very pretty picture for him and makes the stress/book keeping story hard to believe.

 

Yeah, the bookkeeping thing is possible, although I don't think I've ever heard of anyone not doing their paperwork the same day (but definitely not all docs will do it immediately after/during seeing a specific pt). I think the major lapse in judgment was requesting loans from patients. I mean, it's hard to imagine that a bank wouldn't raise his credit card limit or open a line of credit so he could get that $3000 within a day or two - something must be up, he's gotta be buried in debt and/or have a bad credit history or something. And even then, these shady payday loan places that you see all over town will lend $ to ANYONE with a job without a credit check, so he had absolutely no excuse to ask these men for a loan. I think he needs some major financial counselling, at the very least.

[sfuguy]

what about the principles of autonomy and self determination... i love ethics, you can never be wrong , what if his intention was never to practice family medicine but make lots of money and travel the world, suppose he wasn't the type that looked to find deep personal satisfaction in work but rather in other endeavours in life, which are made possible by his acne practice... i hear the education is subsidized and you owe something to society argument coming , but if i'm making 900 k, i'll gladly pay back the 500 k i was subsidized with to make such an exorbitant salary

 

if i could get away with running an acne clinic and making 900 k i'd do it for a few years, sorry to all you guys suffering in internal medicine residences

 

To add to this...what's wrong with helping people look better??? It increases people's self esteem and quality of life. Isn't that what every physician tries to do anyway?

 

If med school is subsidized, then he will pay a good portion back through tax on 900k!!!

 

Good for him!

[NLengr]

Well, the gold standard for elective hernia repair, though I'd be interested in seeing some robust outcomes evidence that it's superior to mesh repairs and the like.

 

In any case, doing nothing but elective abdominal wall defect repair is the absolute most boring thing to do with an FRCSC in general surgery.

 

I think there is some good evidence that I read a while ago. It's not the technique though. It's the fact that they do it over and over. If you don't do that volume the results are worse than mesh. That's how I remember it anyway.

[The Journey Man]

Plenty of family physicians do this stuff - You don't need to be trained in general surgery or a surgical residency to do surgical procedures.

 

Remember in Family medicine training, you are trained to do a little bit of everything, including some small surgeries. Thats why in rural places, if given privileges, family docs can do this. They just need to learn the procedures well enough and there not to be competition from people with superior training for a hospital to give them privileges

 

The guy whos doing hair transplants and such likely got the appropriate training somewhere - whether that be through formal fellowship or working for a plastic surgeon etc. - at least enough training so they wont get sued.

[BoyInTheBubble]

I think there is some good evidence that I read a while ago. It's not the technique though. It's the fact that they do it over and over. If you don't do that volume the results are worse than mesh. That's how I remember it anyway.

 

The volume is a key feature of Shouldice's success, but I believe their results stem from highly specific patient selection.

 

Morbidity and mortality rates for almost all of medicine would likely decrease if you never treated obese, diabetic, vasculopaths. They leave all the 'tough' cases for the surgeons with appropriate training. I'm not saying Shouldice isn't valuable - it is because there are so many skinny people with hernias - but they 'cream skim'.